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Enteral Nutrition Therapy


Enteral means “utilizing the gut,” so normal eating and drinking are both examples of enteral nutrition.  In homecare, we often think of enteral nutrition as the liquid that goes through a tube into your stomach or small intestine.  An enteral feeding program is necessary when you cannot eat an adequate amount of nourishment to sustain life by mouth but your digestive system is at least partially functioning. Home enteral nutrition (HEN) refers to enteral feeding administered in the home setting. HEN provides the appropriate amount of calories, nutrients, protein, carbohydrates, fats and essential vitamins and minerals. The therapy may be for only a few weeks or a lifetime. The formula may be taken orally, bolus (syringe), gravity (feeding bag), or by an enteral electronic pump. With time, training, and experience; people using enteral nutrition at home can have an improved quality of life.


Benefits and services our team offers:

  • Each patient is assisted by a representative specialized in enteral nutrition
  • Hospital set-ups and teaching at bedside to educate the patient and caregiver on set up and administration
  • Clinical Registered Nurse (RN) and Registered Dietitian (RD) visits available
  • Our team is there every step of the way to help patients become independent and resume normal daily activities as much as possible
  • Ongoing monitoring and communication with the physician regarding patient’s progress
  • 24/7/365 clinical support

Conditions treated with Enteral Nutrition Therapy

Adults:

  • Head and Neck Cancer
  • Esophageal Cancer
  • ALS
  • Pancreatitis/Malabsorption
  • CVA/Stroke
  • Motility Disorders
  • Dysphagia
  • Aspiration Pneumonia
  • Esophageal Problems
    • Obstruction
    • Ulceration
    • Stricture
    • Fistula
    • Paralysis
  • Multiple Sclerosis
  • Head Injuries
  • Hemorrhages
  • Quadriplegia

Pediatrics:

  • Chronic Conditions
    • Cerebral Palsy
    • Cystic Fibrosis
  • Failure to Thrive
  • Prematurity
  • Gastrointestinal Esophageal Reflux
  • Metabolic Diseases – Inborn Errors of Metabolism
  • Many More

Total Parenteral Nutrition (TPN)


400,000+ people are living at home on parenteral nutrition

When we eat, our body breaks down the food through digestion into small nutritional elements.  These elements are then absorbed into our blood so they can be used for energy and to support life.  If an illness or an obstruction occurs and a person cannot digest food normally, these nutritional elements can be provided by directly infusing them into the blood stream.  This form of intravenous therapy is called parenteral nutrition (PN). Parenteral nutrition can provide all the nutrients a person needs to maintain health, however, it does not affect a person’s ability to eat.  Over 400,000 people in the US, Europe, and Canada are living at home on parenteral nutrition.

There are two types of parenteral nutrition: Total Parenteral Nutrition (TPN) & Peripheral/Partial Parenteral Nutrition (PPN).  TPN is infused into a large vein in the body and can provide a fairly concentrated formula to meet the nutritional needs of each individual.  TPN infused through a large vein can be long term; months or years, if needed.  PPN is infused in a smaller vein in the arm and is not as concentrated as TPN; it is also only used for the short term; a week or two at the most.

Parenteral nutrition infusion therapy can be adjusted to fit each patient’s lifestyle.  To enable mobility and independence a patient is given a portable pump and backpack in order to enjoy a normal routine even while receiving their nutrition infusion. Other patients choose to receive their nutrition infusion therapy at night. Home TPN therapy can be administered safely and effectively in the comfort of the patient’s home thus reducing and/or preventing the need for extended hospitalization.

Benefits and services our team offers:

  • Each patient is followed by a clinical team of experts who specialize in parenteral nutrition infusion therapy
  • Home visits by skilled nurses to educate the patient and caregiver on set up and administration of parenteral nutrition, line care, assessment, and lab draws as ordered
  • Our team is there every step of the way to help patients become independent and resume normal daily activities as much as possible
  • A skilled support team of pharmacists, nurses and dietitians to collaborate with the patient’s healthcare team and physician in order to create the best nutrition plan for the patient while on, or transitioning off PN
  • Ongoing monitoring and communication with the physician regarding patient’s progress
  • 24/7/365 clinical support

Conditions Treated with Parenteral Nutrition Therapy

  • Short Bowel Syndrome
  • Mechanical Bowel Obstruction
  • Malabsorption
  • Crohn’s Disease
  • Ulcerative Colitis
  • Massive Bowel Resection
  • Enteritis
  • Bowel Dysmotility

Conditions requiring bowel rest such as severe Pancreatitis and Bowel Fistulas

Severe malnutrition with mechanical inability to eat and failed tube feeding trial 


Intradialytic Parental Nutrition (IDPN)


IDPN is a form of intravenous nutrition that can be given to malnourished hemodialysis patients. Approximately 5% to 10% of people on chronic hemodialysis experience problems with eating adequately or absorbing what they do eat even though their diet has been liberalized and they have tried oral supplements.   Due to this, a person can become malnourished and often lose weight and have poor protein stores.  This can lead to an increased susceptibility to infection and increased medical complications.

IDPN is infused at the same time a patient receives his/her dialysis treatment so administration is very convenient.

People who have received IDPN therapy have experienced increased energy and strength, increase in appetite, improved wound healing, and healthy weight gain.

Benefits and Services our team offers: 

  • Expert clinical team including pharmacists and dietitians who can assess the patient’s nutrition needs and develop an IDPN formula to meet those needs
  • Ongoing monitoring of labs, weight, and nutritional status to ensure each patient is progressing and no complications arise
  • Personalized care for each patient on IDPN
  • Pharmacist, Nurse, and Dietitian available to answer any questions the patient or the physician may have

Conditions Treated with IDPN

Hemodialysis patients who are malnourished


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